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Stability of the elbow joint: relevant anatomy and clinical implications of in vitro biomechanical studies.

de Haan J, Schep NW, Eygendaal D, Kleinrensink GJ, Tuinebreijer WE, den Hartog D - Open Orthop J (2011)

Bottom Line: The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies.The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed and EMBASE electronic databases and the Cochrane Central Register of Controlled Trials were searched.Studies were eligible for inclusion if they included observations of the anatomy and biomechanics of the elbow joint in human anatomic specimens.Numerous studies of the kinematics, kinesiology and anatomy of the elbow joint in human anatomic specimens yielded important and interesting implications for trauma and orthopaedic surgeons.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery-Traumatology, Westfriesgasthuis, P.O. Box 600, 1620 AR Hoorn, The Netherlands.

ABSTRACT
The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies. The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed and EMBASE electronic databases and the Cochrane Central Register of Controlled Trials were searched. Studies were eligible for inclusion if they included observations of the anatomy and biomechanics of the elbow joint in human anatomic specimens.Numerous studies of the kinematics, kinesiology and anatomy of the elbow joint in human anatomic specimens yielded important and interesting implications for trauma and orthopaedic surgeons.

No MeSH data available.


Related in: MedlinePlus

The two contrasting complications of elbow joint dislocations: stiffness and instability.
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Figure 1: The two contrasting complications of elbow joint dislocations: stiffness and instability.

Mentions: Elbow dislocations are classified as simple or complex [3]. Simple dislocations are dislocations without fractures. Complex dislocations are associated with fractures of the distal humerus, radial head, proximal ulna and/or coronoid process. The combination of an elbow dislocation with a fracture of the radial head and the coronoid process is called a “terrible triad” due to the high rate of complications. Surgeons treating elbow dislocation are concerned about two complications: stiffness and instability of the elbow joint. Stiffness or restricted range of motion and instability can be seen as contrasts on a seesaw (Fig. 1). Range of motion can be measured reliably with a standard goniometer for assessing stiffness [4]. Instability can be classified, according to the timing, as acute or chronic instability or recurrent dislocation. In a review of simple elbow dislocation, including eight studies with a total of 342 patients, only one recurrent dislocation was mentioned [5]. Despite this low recurrence rate, surgeons prefer long immobilisation to prevent instability over early functional treatment to prevent restricted range of motion [6]. This preference is valid because it is easier to treat stiffness than instability of the elbow joint. For most activities of daily living, restricted range of motion is not a major problem. In a study by Morrey et al., most of the activities of daily living could be accomplished with a 100° arc of motion (from 30° to 130°) and 100° of forearm rotation (50° of pronation and 50° of supination) [7].


Stability of the elbow joint: relevant anatomy and clinical implications of in vitro biomechanical studies.

de Haan J, Schep NW, Eygendaal D, Kleinrensink GJ, Tuinebreijer WE, den Hartog D - Open Orthop J (2011)

The two contrasting complications of elbow joint dislocations: stiffness and instability.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104563&req=5

Figure 1: The two contrasting complications of elbow joint dislocations: stiffness and instability.
Mentions: Elbow dislocations are classified as simple or complex [3]. Simple dislocations are dislocations without fractures. Complex dislocations are associated with fractures of the distal humerus, radial head, proximal ulna and/or coronoid process. The combination of an elbow dislocation with a fracture of the radial head and the coronoid process is called a “terrible triad” due to the high rate of complications. Surgeons treating elbow dislocation are concerned about two complications: stiffness and instability of the elbow joint. Stiffness or restricted range of motion and instability can be seen as contrasts on a seesaw (Fig. 1). Range of motion can be measured reliably with a standard goniometer for assessing stiffness [4]. Instability can be classified, according to the timing, as acute or chronic instability or recurrent dislocation. In a review of simple elbow dislocation, including eight studies with a total of 342 patients, only one recurrent dislocation was mentioned [5]. Despite this low recurrence rate, surgeons prefer long immobilisation to prevent instability over early functional treatment to prevent restricted range of motion [6]. This preference is valid because it is easier to treat stiffness than instability of the elbow joint. For most activities of daily living, restricted range of motion is not a major problem. In a study by Morrey et al., most of the activities of daily living could be accomplished with a 100° arc of motion (from 30° to 130°) and 100° of forearm rotation (50° of pronation and 50° of supination) [7].

Bottom Line: The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies.The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed and EMBASE electronic databases and the Cochrane Central Register of Controlled Trials were searched.Studies were eligible for inclusion if they included observations of the anatomy and biomechanics of the elbow joint in human anatomic specimens.Numerous studies of the kinematics, kinesiology and anatomy of the elbow joint in human anatomic specimens yielded important and interesting implications for trauma and orthopaedic surgeons.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery-Traumatology, Westfriesgasthuis, P.O. Box 600, 1620 AR Hoorn, The Netherlands.

ABSTRACT
The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies. The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed and EMBASE electronic databases and the Cochrane Central Register of Controlled Trials were searched. Studies were eligible for inclusion if they included observations of the anatomy and biomechanics of the elbow joint in human anatomic specimens.Numerous studies of the kinematics, kinesiology and anatomy of the elbow joint in human anatomic specimens yielded important and interesting implications for trauma and orthopaedic surgeons.

No MeSH data available.


Related in: MedlinePlus